Whistleblower Fraud Data in Healthcare Claims and False Claims Act Cases and Recoveries

HEALTHCARE FRAUD: ANNUAL WHISTLEBLOWER RECOVERIES

Once again, in fiscal year 2018 health care fraud cases represented the overwhelming majority of successful qui tam cases filed under the federal False Claims Act. Nearly 90% of the money recovered under the False Claims Act last year—a total of $2.51 billion—was recovered in health care fraud cases. This is no surprise, given that health care costs constitute nearly 20% of our country’s gross domestic product, over $3 trillion per year. Almost half of that cost is paid by taxpayers with our tax dollars. We spend more than $650 billion a year on Medicare; states spend over $550 billion a year on Medicaid. These massive numbers invite massive fraud on taxpayers, with billions of dollars in Medicare and Medicaid fraud wasted each year. Whistleblowers are essential to identifying health care fraud and holding its perpetrators responsible. Whether unlawful drug pricing schemes, improper hospital, long-term care facility, hospice, or home health care billing, unlawful kickbacks, and scores of other payment arrangements made in violation of law, without qui tam whistleblowers the government is not equipped to investigate most of it. Whistleblowers also need top-quality counsel to bring quality cases in the right way, in order to maximize their potential rewards. Contact our firm Hagens Berman, one of the nation’s most successful law firms representing whistleblowers, to discuss your potential health care fraud case.

FALSE CLAIMS ACT CASES: NEW QUI TAM MATTERS

Each year several hundred whistleblowers file cases under the qui tam provisions of the federal False Claims Act. In fiscal year 2018, whistleblowers filed 645 new qui tam cases under the federal False Claims Act. That amounts to more than 12 qui tam cases filed every week in our federal district courts. On average, only a few dozen of these cases will result in significant False Claims Act victories—or victories at all. The Department of Justice also has to review and potentially investigate every one of those cases. The great majority of those cases will be unsuccessful. Some of them are unsuccessful because the whistleblower’s allegations simply do not add up to a violation of the False Claims Act. Other cases, however, are simply poorly researched and poorly presented to the Department of Justice at the time of filing. Some of those cases have merit and deserve to be properly investigated. With limited resources, however, the Department of Justice has to focus on cases that present with the most compelling evidence of significant fraud. For that reason, it is critically important for whistleblowers to hire the best law firm to present their case to the government, and ultimately to litigate their case if necessary.  Contact our firm Hagens Berman, one of the nation’s most successful law firms representing whistleblowers, to discuss your potential False Claims Act fraud case.

FALSE CLAIMS ACT RECOVERIES: STOPPING FRAUD

The federal False Claims Act continues to operate as the government’s primary tool for investigating fraud on taxpayers and recovering significant money from wrongdoers who rip all of us off. In fiscal year 2018, federal False Claims Act recoveries amounted to $2.88 billion. $2.1 billion of those recoveries was a result of qui tam whistleblowers who filed lawsuits under the False Claims Act and were rewarded for doing so. In 2018, whistleblowers received a total of $301.7 million in rewards for bringing quality cases that led to recoveries under the False Claims Act. This figures includes tens of millions of dollars awarded to health care fraud whistleblowers, defense contract whistleblowers, financial fraud whistleblowers, and others. More than $30 million was paid to whistleblowers in cases where the federal government declined to litigate the case and the whistleblower litigated the case with counsel on his or her own. The Department of Justice is stretched thin with resources and in many instances relies upon whistleblowers and their law firms to carry the laboring oar in litigating quality False Claims Act cases across the country. Contact our firm Hagens Berman, one of the nation’s most successful law firms representing whistleblowers, to discuss your potential False Claims Act fraud case.

Shayne C. Stevenson is a partner at Seattle’s Hagens Berman, a nationally recognized plaintiffs’ law firm. He leads its whistleblower practice, representing whistleblowers under False Claims Act statutes and whistleblower programs for the IRS, SEC and CFTC.